SRISAMORN BANCHAM Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041195968

License Status

INACTIVE

Business

First Name

SRISAMORN

Last Name

BANCHAM

Business Name

SRISAMORN BANCHAM

Original Issue Date

07/03/1980

Effective Date

07/03/1980

Expiration Date

05/31/1988

City

WEST COVINA

State

Zip

91790

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

09/27/2006